Avaliação da expressão de CD34 e ICAM-1 e das alterações vasculares na pele de pacientes com psoríase em placas, pustulosa e eritrodérmica

• Autor(a) principal: Bressan, Aline Lopes
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/8816
• topic: Psoriasis; CD34; ICAM-1; Capillaries; Immunohistochemistry; Psoríase; CD34; ICAM-1; CD54; Capilares; Imuno-histoquímica; Psoríase; Imunohistoquímica; Capilares; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DERMATOLOGIA

Psoriasis is a chronic inflammatory disease, with no predilection for sex and age, with immunologic activation, characterized by erythematous-desquamative lesions. Its development depends on genetic factors, or external triggering stimuli and changes in the immune system, with activation of T lymphocytes. The clinical forms are: plaque, guttate, inverted, pustular, erythrodermic and arthropathica. The disease is considered moderate-severe when it affects more than 10% body surface area (BSA) and severe form occurs in 20-30% of cases. Approximately 350 people die each year due to psoriasis or treatment complications. The more severe forms, such as pustular (pustules spread) and erythrodermic (> 80% of SC affected), are responsible for systemic complications with impaired thermoregulation, dehydration, tachycardia, and therefore, generate the greatest number of admissions. The complication with greater progression to death is systemic capillary leak. Therefore, it was hypothesized that there are differences in the expression of CD34 (cluster of differentiation 34), and ICAM-1 or CD54 (intercellular adhesion molecule) as well as in the vessels in these various forms of psoriasis. This study examined the expression of CD34 and ICAM-1 and the vascular alterations in mild psoriasis (<10% SC), moderate-severe (> 10% SC), pustular and erythrodermic to correlate with disease severity. Also evaluated the presence of comorbidities and demographic profile of patients who underwent clinical examination, peripheral blood collection (4ml) and skin biopsy (two samples, one fixed in formalin and another in the middle Tissue-Tek, stored in liquid nitrogen). The fragment fixed in formalin was subjected to histopathological analysis and immunohistochemistry, the material of this study. The material not used is stored for future analysis. Results: patients included in the study, 22% had the pustular form, 12% erythrodermic, 25% had mild psoriasis plaques and 41% moderate-severe psoriasis plaques. The prevalence of whites was similar to nonwhite, 53% vs. 47% respectively, as well as the division between the sexes, 56% women and 47% men. Hypertension was the most prevalent comorbidity followed by obesity. Conclusion: Psoriasis has no predilection for sex and skin color, with hypertension as more associated comorbidity. Immunohistochemical aspects demonstrate that vascular changes are important in psoriasis, there was an increase in the number of vessels and overexpression of ICAM-1, mainly in the form erythrodermic. ICAM-1 (CD54) expression is associated with increased inflammatory infiltrate and the clinical severity. Therefore we conclude that the vascular changes are the sustaining base of cutaneous and systemic manifestations, being more relevant in erythrodermic psoriasis.